Home Health ICD-9/ICD-10 Alert

Reader Question:

Don't Skimp on Dementia Details

Question: The physician documents that our patient has aggressive behavior due to dementia with Lewy bodies. Do I have to list an additional code for the manifestation of dementia with behavioral disturbance too?

California Subscriber

Answer: Yes, you’ll need to list two codes to properly report this patient’s diagnoses.

First, list 331.82 (Dementia with Lewy bodies). When you reference this code in the tabular list, look up to the note at the category level 331 (Other cerebral degenerations). According to ICD-9 diagnosis coding rules, you should "Use additional code, when applicable, to identify dementia: with behavioral disturbance (294.11); without behavioral disturbance (294.10)."

Adding the manifestation code provides specificity about whether or not there is a behavioral disturbance present. In your patient’s case, list 294.11 (Dementia in conditions classified elsewhere with behavioral disturbance) to acknowledge his aggressive behavior.